Minimally invasive surgical techniques have been developed for many different types of surgical procedures. Such techniques attempt to balance the need to achieve the goal of the surgical procedure while minimizing the surgical injury to the patient. As such, surgeries performed by use of minimally invasive techniques generally result in lower postoperative morbidity, shorter postoperative hospital stay, less postoperative pain, decreased cost, and quicker recovery as compared to “open” or conventional surgical techniques. Because of the aforementioned advantages, these minimally invasive techniques are being applied to an increasing variety of surgical procedures. For example, minimally invasive techniques in the form of laparoscopic procedures, such as a laparoscopic colectomy for carcinoma of the colon, have been developed.
However, despite growing use in other surgical fields, minimally invasive techniques have not been significantly developed for use in orthopaedic procedures. In particular, although orthopaedic surgeons have recognized the general principle that maintenance of soft tissue contributes significantly to the post operative healing process, conventional techniques in which the soft tissue is completely opened to gain complete access to the bone structure thereunder are still in wide spread use. One reason for this is the unique nature of many orthopaedic procedures. In particular, orthopaedic procedures often involve the “delivery” (i.e., implantation) of devices which are relatively large in design compared to the “deliverables” associated with other forms of surgery. Specifically, in the case of, for example, an appendectomy, minimally invasive techniques are readily adaptable since the surgeon may aptly remove the subject tissue (i.e., the patient's appendix) and thereafter deliver and install the necessary sutures through the relatively small confines of a cannula of a trocar. However, in the case of, for example, trauma repair of a heavily fractured long bone (e.g., a femur or tibia), a number of relatively large plates are screwed or otherwise fastened to the fracture bone. The size of such plates has long since been viewed as prohibiting in regard to the use of minimally invasive techniques for the implantation of such components.
As such, orthopaedic surgeons have typically preferred to open the soft tissue surrounding the bone to be treated in order to completely expose the surgical site thereby providing for ease of plate delivery. As a result of such continued use of “open” procedures, soft tissue surrounding the bone continues to be compromised thereby impairing normal blood circulation to the treated bone, potentially delaying fracture healing, and potentially increasing the risk of infection. Indeed, although the majority of patients treated with such procedures heal without complication, there are certain occasions in which complications such as infection or refracture occur thereby prolonging healing rates and, in certain cases, increasing the rates of secondary revisions.
As a result of the aforedescribed shortcomings associated with traditional orthopaedic surgeries, along with the promise associated with minimally invasive techniques, a number of attempts have been made to provide certain of the advantages associated with minimally invasive techniques to certain orthopaedic procedures. For example, plate fixation assemblies have heretofore been developed for use in fracture repair of femurs. However, such assemblies suffer from a number of drawbacks. For example, such assemblies suffer from a certain degree of inflexibility in regard to the manner in which the orthopaedic component is implanted. For instance, the prosthesis utilized with such assemblies must generally be “pre-assembled” prior to implantation thereof. Specifically, since it is difficult, if not impossible, for the surgeon to visualize the implanted prosthesis, in vivo assembly of the prosthesis is rendered equally difficult, if not impossible.
What is needed therefore is an apparatus and method for use in the performance of minimally invasive orthopaedic procedures which overcome one or more of the above-mentioned drawbacks.